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Clinical Anatomy of the Puboprostatic Ligament for the Safe Guidance for the Prostate Surgery

Authors
 Hyun-Min Choi  ;  So-Young Jung  ;  Soo-Jung Kim  ;  Hee-Jun Yang  ;  Jang-Hwan Kim  ;  Young-Tae Kim  ;  Ji-Cheol Shin  ;  Hye-Yeon Lee 
Citation
 UROLOGY, Vol.136 : 190-195, 2020 
Journal Title
UROLOGY
ISSN
 0090-4295 
Issue Date
2020
MeSH
Aged ; Aged, 80 and over ; Cadaver ; Humans ; Ligaments/anatomy & histology* ; Male ; Middle Aged ; Prostate/anatomy & histology* ; Prostatectomy/methods* ; Pubic Bone/anatomy & histology*
Abstract
OBJECTIVE:

To provide the anatomy of the puboprostatic ligament and related structures to save urogenital competence after prostatectomy.

MATERIALS AND METHODS:

Pelvic areas of 31 adult cadavers were dissected to figure out the shape, number, and location of the puboprostatic ligaments.

RESULTS:

The puboprostatic ligament was the most important support structure between the pubic bone and prostate gland. Puboprostatic ligaments were bilaterally single (61.3%), bilaterally double (19.4%), or mixed (19.4%). Ligaments were mostly I-shaped (53.8%). If ligaments had extra attachment to or from the arcuate line, the ligaments were λ-shaped (36.3%), or Y-shaped (8.8%). In one case, the ligament had a central fusion with an irregular shape. I-shaped puboprostatic ligaments were observed more frequently in specimens with double ligaments, while λ-shaped puboprostatic ligaments were observed more frequently in the cases with single ligaments. The average distance between both puboprostatic ligaments was 8.1 mm at the pubic site and 14.2 mm at the prostate site. The distance was narrower when the specimen had double puboprostatic ligaments on both sides. The neurovascular bundle ran beneath the puboprostatic ligament. If the ligament was the λ-shaped type, the neurovascular bundle frequently pierced the lateral band of the ligament.

CONCLUSION:

Puboprostatic ligaments hold and stabilize the prostate against the pubic bone. It is believed that a pelvis with bilateral, double puboprostatic ligaments would have advantages in urogenital competence. The morphologic data of the shape, multiplicity, and location of the PPLs would help to make a plan to approach the prostate.
Files in This Item:
T202000813.pdf Download
DOI
10.1016/j.urology.2019.10.015
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Kim, Jang Hwan(김장환) ORCID logo https://orcid.org/0000-0002-9056-7072
Shin, Ji Cheol(신지철) ORCID logo https://orcid.org/0000-0002-1133-1361
Lee, Hye Yeon(이혜연) ORCID logo https://orcid.org/0000-0001-6945-1967
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175605
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